THE NEW TUMOR-MARKER CYFRA IS SUPERIOR TO SCC ANTIGEN AND CEA IN THE PRIMARY DIAGNOSIS OF LUNG-CANCER

The diagnostic value of the new tumor marker CYFRA in lung cancer was assessed in comparison to squamous cell carcinoma (SCC) antigen and ca rcinoembryonic antigen (CEA). CYFRA was pretherapeutically elevated in 60.9 % (cutoff: 3.3ng/ml), SCC antigen in 33.1 % (cutoff: 1.5ng/ml), and CEA in 53.4 % (cutoff: 5ng/ml) of patients with lung cancer (N=133 ). In respect to the histologic types, CYFRA was elevated in 66.7 % of squamous cell carcinoma (SCC antigen: 49.1 %, CEA: 43.9 %), in 68.2 % of small cell carcinoma (SCC antigen: 4.5 %, CEA: 63.6 %), in 46.2 % of adenocarcinoma (SCC antigen: 20.5 %, CEA: 56.4 %), and in 66.7 % of large cell carcinoma (SCC antigen: 46.7 %, CEA: 66.7%). Unlike SCC an tigen and CEA, the sensitivity of CYFRA correlated with the extent of the malignant disease. Elevated CYFRA values were measured in 27.3 % ( SCC antigen: 18.2 %, CEA: 36.4 %) of stage TNM 1, in 41.7 % (SCC antig en: 50.0 %, CEA: 33.3 %) of stage TNM II, in 46.4 % (SCC antigen: 39.3 %, CEA: 50.0 %) of stage TNM IIIa, in 71.4% (SCC antigen: 28.6%, CEA 42.9 %) of stage TNM III b, and in 75.0 % (SCC antigen: 31.2 %, CEA: 7 0.8 %) of stage TNM IV False positive elevations in benign lung diseas es (N = 50) occurred at a rate of 4 % for CYFRA, 4 % for SCC antigen, and 16 % for CEA. The overall diagnostic accuracy was 70.5 % for CYFRA , 50.3 % for SCC antigen, and 61.7 % for CEA, implying that CYFRA best discriminated between lung cancer and benign lung diseases, while SCC antigen and CEA were less efficient as diagnostic markers in primary lung cancer.